Surgical Procedures -

Operative Laparoscopy

Operative laparoscopy has gained tremendous acceptance and publicity for one reason: recovery after the procedure is much easier and shorter. Physicians are still discussing why this is the case.

Some of the suggested reasons include:

• A smaller incision is made in the abdomen (2 or 3 1/2 inch cuts or less) compared to 3 or 4 inches in open surgery (laparotomy).

• Use of carbon dioxide seems to be tolerated better than exposure of the inside of the abdomen to the room air.

• Better visualization of individual pelvic organs, frequently compared to the surgeon having an "eye on the end of the scope."

There may other reasons which are not well understood and are still being discussed.

The field of operative laparoscopy is ever-increasing. At its beginning approximately 30 years ago, the cutting of adhesions, aspirations of cysts, or burning of intra-abdominal lesions, most frequently Endometriosis, was considered to be a risky procedure. Now laparoscopy has evolved to a state where removal of the uterus, kidney, ovaries, etc. are common procedures. Removal of the appendix and gall bladder, together with laparoscopically-assisted vaginal hysterectomy, are typical procedures which show a significantly lesser recuperation time and less pain.

Some time ago, laparoscopy was a special privilege for gynecological surgeons, who had to prove their skills, training and abilities prior to being allowed to perform these more involved abdominal procedures. Nowadays, training in laparoscopy, diagnostic as well as operative, is part of every residency training program.

Surgical Procedures